The Accidental Medical Tourist

Some trips are just meant to be more memorable. And this one was.

As I planned for Australia and New Zealand, I had it all figured out. A mixture of an amazing cruise on Crystal, land tours hitting spots I’d longed to see and which weren’t included in the cruise itinerary. Big adventure combined with total indulgence. My article on a day of bungee jumping followed by an evening of complete pampering at one of Conde Nast’s top 10 spas in the world was already sketched out in my mind. Two days of wine touring in some of the best wine regions in the world. Maori culture. Snorkeling with whale sharks and dolphins. And penguins too! A heap of new knowledge with which to help my clients. Plus a visit with my best friend. Who wouldn’t be excited?

It didn’t work out that way.

Instead, I got a reminder about how things can change. And practice in dealing with some of the worst that can be thrown at a traveler. Coping my way through it all on my own. Where was my travel agent when I needed her? In all honesty, even with all the resources I had at my disposal, I can’t imagine going through everything without an agent on my side. Even if that agent had to be me.

I thought of and tried out a lot of potential titles for this article. When bad things happen to good travel agents? Nope, that’s a bit too conceited. Up in the air and down under? Cute, but not right.

The Accidental Medical Tourist. Yes, that’s the one. Medical tourism is a huge market and growing every year. I just didn’t expect to be included in those numbers. Not now. Not without coming home looking “rested” or at least nipped and tucked.

My long time readers and clients will know that I’m a huge proponent of travel insurance for a number of reasons many of which are due to personal experience. Heading down to South America a couple years ago, a flight got cancelled and I had to be put up for 24 hours and re-arrange the schedule. Before that, in China, I’d contracted pneumonia and bronchitis, ended up on IV antibiotics in Beijing and had to stay over several extra days until ready to fly. Along with other assorted personal travel glitches. Not to mention everything from noro incidents, hurricanes, missed port calls with cancelled excursions, and family emergencies which my clients have faced. Now I have yet another reason to help those on the fence about trip insurance realize it really is an important part of travel for everyone.

For years, I’ve talked with my clients facing long plane rides about strategies to make it safer and easier on them. Limit alcohol and caffeine. Drink lots of water. Move around as much as possible. Choose airlines with as much leg room as you can. Upgrades using points as the best use of all those accumulated miles in your account if you can. Purel everything. And so forth. I’ve personally flown the two longest non-stop flights in the world (Los Angeles to Singapore and Singapore to Newark)… four times. I think of a Transatlantic flight as only one good James Patterson novel in length. So you think I’d be fine on a routine flight from San Francisco to Sydney, especially with a lay-flat business class seat, right?

Wrong.

Long story very short, when I arrived in Sydney and deplaned, I couldn’t breathe. Had a hint of something not quite right on the plane, but it became painfully clear (pardon the pun) when I exited the plane and started walking to immigration. Was taken on a gurney by paramedics straight from the luggage hall in Sydney International to the closest hospital, exiting out through the back halls of customs with a personal customs officer as my escort. It was definitely one way to get around the sometimes onerous agricultural inspections in Australia. But I wouldn’t recommend it.

As you may have guessed, I had developed blood clots in my lungs on the flight. Both lungs. Probably caused by deep vein thrombosis (DVT) in my legs or pelvis, but no way to know for sure. Perhaps I didn’t move around enough (I was sleeping very soundly) or wasn’t fully hydrated. Could even be a genetic predisposition to which we were previously unaware. Maybe just one of those things we’ll never know. Regardless, there I was, in the hospital. Alone. In a foreign country where they speak a form of English. Thankfully.

This all happened two days after the health care vote in the US. Let’s say treading the mine field of questions asked by the medical professionals who were responsible for my care that first day may have been one of the most difficult parts of the experience. Combine that with the hospital ward to which I was admitted which wasn’t sex-segregated and a young Indian “gentleman” who leered at me across the room from his hospital bed every time his mother left the room, and that first day was rather interesting.

I had unintentionally become a medical tourist in a foreign hospital. Most medical tourism these days is well planned, quite comfortable, and to save money over similar procedures in the US. Not me. I had to do things the hard way.

So, being all alone as the solo traveler I usually am, who did I call when I first obtained my diagnosis and was admitted? Did I call family? My closest friend who happens to live in Australia? Of course not. I called my trip insurer. And then emailed them quite a lot while they coordinated my care, discharge, changes in plans and eventual evacuation back home when I was finally cleared to fly again. Oh do I love unlimited Blackberry international email! Not to mention Skype!

I have to thank all the individuals who helped make this incident more bearable. The medical staff at both the public and private hospitals were fantastic. The ER physician in particular who wouldn’t give up without a clear diagnosis was amazing. The thoracic physician and his assistant whose descriptions of A Midsummer Night’s Dream almost made up for missing it at the Sydney Opera House. Jean-Philippe, the General Manager of the Sydney Harbour Marriott who, when he learned I had just been discharged from the hospital, brought me slippers and a gift of lovely bath toiletries so I’d feel more comfortable during my stay at his hotel. The wonderful doctor and nurses on Crystal Symphony who brightened my cruise every day at 5P when I’d visit. Roland, Josef and Bart made everything happen and be memorable in the incomparable Crystal way. Of course my new friends from the Avenue Saloon, Sushi Bar and Vintage Room who kept me laughing and sane throughout, and whom I now miss terribly. And Kristin, who though she was on the other side of the continent, listened every time I had an emotional break down and whom I know would have been at my side if I’d really needed her.

But the good memories and experiences wouldn’t have happened if it weren’t for my trip insurance. While yes there were times when I had to navigate the bureaucracy of it all, just like everyone, they still made it work all the while making sure to keep me safe and monitored. I wasn’t alone. They watched out for me.

Of all the scenarios involving pulmonary emboli, I was extremely lucky. I know one of my 9 lives is gone forever. I’m thankful to be here.

So for those who think they can travel without insurance, think again. This or other medical events can happen to anyone. At any time. On a 14 hour Transpacific flight in business class or a 2-hour hop on Southwest to Ft. Lauderdale. In the car driving to the port. Or to your favorite Aunt Betty at home when you’re on a cruise in St. Thomas. My primary insurance is picking up much of the medical costs, but the trip insurance is covering the tens of thousands of dollars in evacuation expenses to get me home, my considerable deductable, the housing in Sydney while I recuperated, the upgrade to a private hospital and other uncovered medical items, the cancelled flights, excursions and other plans, and the dozens of other miscellanea.

I won’t be flying for awhile. But I’m home, recovering, and financially no worse for wear. I have memories which will last me a lifetime. Just very different ones from what was planned. Unlike William Hurt in “The Accidental Tourist” I embrace all the unknowns about travel. I’m always the enthusiastic traveler. As The Accidental Medical Tourist in my own life story, I found the joy in the situation and what unfolded. Not the trip I planned. But probably even more memorable in many ways. I was free to enjoy what could be achieved on this trip thanks to trip insurance. Be an explorer, but be covered.

Yes, I did get a lot of new information about Australia and New Zealand. I know Sydney far better than I’d planned (which is a very good thing). I did get to most of the ports and tasted the wine (and chocolate!), even if it wasn’t as much as I’d hoped. I learned more about what my clients who are physically challenged face on a cruise and can now better guide them in these areas. Because I went at a slower pace in ports, I got to talk more with people even as I “did” less. So I ended up learning even more in unexpected places. A successful trip for any travel agent I’d have to say. And even a success for this adventurous traveler.

I can’t wait to go back and do all those planned activities and experiences I missed. And I will. I can because I had trip insurance.

Maybe now since I’ve already been a medical tourist, I should investigate the nip and tuck in Singapore next time I head out that way… Nah. Not quite yet at least. Ask me again in 10 years.

New Ships, Cruising and the Economy

In talking with clients recently, two questions are asked most frequently: Are things busy for you and how is the cruise industry? We're all reading about how hard the travel industry is being hit by the current economic conditions, but what isn't being widely reported is how well the cruise industry is positioned not just to ride it out, but to do well overall.

Recently, both Carnival and Princess announced record call volumes during the peak booking months of January and February. The cruise lines helped drive these calls with some pretty spectacular offers, but there are always offers during the "wave" season. Consumers responded to these offers this year in unprecedented numbers, reinforcing the strength in the industry.

One of the greatest assets the cruise industry has is the mobility of its product. No, not just that the ships go to multiple destinations, but that the industry can react fairly quickly to changing demand. We're about to see the release of the 2010/2011 schedules, and I'm predicting that "home port" cruising from ports such as Baltimore, New York and similar formerly "secondary" markets will see an increase in the number of ships along with larger, newer ships being ported in these locations. Why? Because it's increasingly harder for cruisers to fly to the more "traditional" ports in Florida and the like due to the airline cutbacks. So if the cruisers can't easily get to the ships, the ships will come to the cruisers.

Likewise, I also expect to see more ships sailing in Europe or other areas for longer periods of time. Both with itinerary changes to bring them into the Europe markets earlier in the season (which we're already seeing), more assigned year-round, and also ships being transferred to the European sister brands of the American lines. Just like in the US, Europeans are looking to cruise closer to home, and their market is expanding rapidly, both for the US brands, and also the brands which are based in and targeted toward Europeans. Because of low-cost intra-Europe air and easily-available charters to places such as Dubai, Europeans can more easily travel in that region than fly to the US or the Caribbean, and they're taking advantage of it.

Yes, cruise fares are a bit lower right now overall, but in traditional peak periods, like the spring break period we're going into, the fares and demand both are extremely strong. Summer Caribbean bookings for families are looking similarly positive for the industry.

But what about newbuilds? Can the industry absorb the new ships and berths which are already in the pipeline? I say absolutely, and point to a couple key indicators.

First, there was quite a bit of question until very recently of whether the Norwegian Cruise Line's F3 project was going to be cancelled. Even before the market changes, there were design cost overruns on the ship, and NCL was looking at their options to draw back. But negotiations continued, and the release of the first ship's name (Norwegian Epic) and newly-released design elements for the ship show that this project is going forward to continue the innovations for which NCL is so well known.

An even larger indication of the strength and power new ships have in the market is, quite literally, the Royal Caribbean Oasis of the Seas project. Set to launch in November, 2009 with inaugural sailing in December, this largest-ever ship is selling extremely well. With prices on her commanding a premium, and strong sales, this ground-breaking ship has and will continue to draw market attention from the press and educate and remind cruisers all the aspects a cruise vacation can cover, further shattering the myth of a "typical" cruise vacation. Knowing Royal Caribbean, there will be a huge media and industry campaign, with lots of paid and free press on all aspects of this launch, bringing even more new passengers into the cruising. Yes, there was a blurb in the SEC filing a couple weeks ago that Royal Caribbean was continuing to negotiate the terms of purchase financing, but that was a legally-required statement and shouldn't have surprised anyone in the markets or industry. Along with most in the industry, I look forward to seeing for myself what this industry-changing ship is like late this year.

Finally, you can see not just my optimism, but my company's (my family of companies is the largest retailer of cruises in the world) along with the largest trip insurer's confidence with our announcement two weeks ago of our partnership with TravelGuard to provide the industry's only "job assurance" protection in our standard trip insurance policy. We know that people want to cruise, and took the step to make it easier to book when you want by taking out the worry of a potential job loss. Do you think an insurer would open themselves to this risk if they didn't feel the industry was strong... and that the economy would support the position?

Cruising continues to increase in popularity, and I don't think we'll see a change in that trend any time soon. I just hope you all take advantage of the price advantages we have right now and schedule your own vacation soon. There's no better value in vacation than cruising, and no better way to get away.

Exciting News! "CruiseAssurance" Trip Protection!

You might have noticed several companies recently offering "job protection" offers on everything from new car purchases to vacations. Recently, Carnival and NCL announced offers of their own for people booking cruises. I've watched with interest these offers, particularly as you can imagine the offers from the cruise lines, but I wasn't too excited about them. In most cases, trip insurance from the cruise lines themselves don't offer enough coverage in my opinion, and these offers didn't go far enough.

So when my company, Cruises Inc., announced to us today that our Travel Guard TravelCompanion policies were being expanded to offer protection in the event of a job loss, I finally had something to get excited about. Especially since there's no increase in the premiums for this additional coverage!

I've been speaking with a lot of my clients recently about adding "cancel for any reason" protection to their Travel Guard policies on their bookings, partially to receive this coverage. But that's no longer necessary... at least not for that reason. (Cancel for any reason can still be beneficial if you're concerned about a pet, have children with uncertain schedules, job issues other than layoffs, etc.) This is a huge value, and exciting to be able to offer to my clients.

Here are the details from our press release:

CRUISES INC. UNVEILS GROUNDBREAKING NEW JOB LOSS INSURANCE, COVERING TRAVEL
ON EVERY CRUISE LINE

Nation’s Largest Cruise Retailer Now Offering “CruiseAssurance” Upgrade (At No Additional Charge) on Bookings March 1-May 2, Raising the Bar by Insuring All Cruise Travelers

Fort Lauderdale, FL – February 27, 2009 – Consumers might be concerned about losing their jobs, but they no longer need to worry about a pink slip ruining their vacation plans. Cruises Inc., the nation’s largest cruise retailer as part of World Travel Holdings, today unveiled the first-ever comprehensive job loss travel insurance policy covering travel on all cruise lines. The new
“CruiseAssurance” initiative is an exclusive benefit to consumers booking through one of more than 450 Cruises Inc. agents nationwide, even if they have to cancel their trip at the last minute because of an unexpected layoff.

The best part? Cruises Inc. is picking up the tab for “CruiseAssurance” for consumers purchasing their basic travel insurance. Combined with lower-than-ever prices, cruising is now the most affordable and worry-free vacation option.

“In today’s environment, it is crucial for businesses to step up to the plate showing we understand consumer challenges, and a handful of companies have recently done this with their
versions of job loss protection,” said Dwain Wall, General Manager of Cruises Inc. “Our ‘CruiseAssurance’ policy takes the concept of job loss insurance to a new level, easing the concerns of consumers at no charge and on any cruise line of their choice.”

Under the “CruiseAssurance” policy, travelers booking a cruise with Cruises Inc. can cancel their trip up to the day of departure, or even during the vacation. The only requirements are that
travelers purchase an entry-level travel insurance plan from their Cruises Inc. agent – administered by Travel Guard – and present their termination letter. One year of employment is required. “CruiseAssurance” applies to bookings made March 1 through May 2, 2009 and is offered in addition to an already comprehensive travel protection policy.

“We have our finger on the pulse of what is happening with consumers and travel, and we are
passionate about finding innovative ways to problem-solve, making cruise travel accessible and affordable for everyone,” said Wall.

So if you've been thinking about booking a cruise, but were waiting due to uncertain job situation, wait no longer! Contact me for more information or to book your cruise!

Good News on Trip Insurance!

My clients know that I've long recommended independent insurance rather than purchasing through the travel supplier - better coverage, lower cost, additional protection. However, the standard policy my company offered, a specifically-negotiated policy with TravelGuard, still had some purchase restrictions if you needed pre-existing coverage. I'm happy to announce that's no longer the case!

TravelGuard has long been my preferred supplier, even though I do represent other companies as well. I personally think that their top-rated traveler's assistance is the best in the business. I've liked the policy we had negotiated, but now I love it. As of this past Monday, you no longer need to purchase the insurance at time of booking (or shortly thereafter) in order to cover pre-existing conditions. You can now have pre-existing conditions waived as long as you purchase the insurance by the time of final payment!

While I still recommend purchasing the insurance when you incur your first non-refundable charge (such as purchasing your flight reservations), this gives passengers more flexibility in budgeting and paying for your cruise. You've always been able to schedule when you make payments for your cruise prior to final payment, now you can budget in and schedule your trip insurance purchase as well.

Remember, this provision is not offered in TravelGuard's other policies. It is specific to the policy my company has negotiated. It's one more way that we work to provide more benefit to you, a higher level of service, and the reason I'm affiliated with this particular company.

As always, we will discuss your specific needs, as sometimes a different policy may be better for your individual situation. But I have to say, this standard policy is going to cover most cruisers' needs quite well. I'm thrilled!

New Insurance Options

Insurance. It's one of those things we hope we don't need, especially in connection with a vacation. But more and more often, situations from medical to family to work interfere with our plans, and insurance becomes invaluable.

My clients know that I strongly recommend trip insurance. Not just for the pre-cruise cancellation benefits, but also possibly more importantly for medical treatment, evacuation or trip interruption benefits during your cruise. But there are several new provisions in insurance which may make insurance even more beneficial to you.

I'm generally not an advocate of insurance through the cruise lines. While I'm happy to offer it, in general (with some specific exceptions, such as Princess when you use Princess air), it's not the best coverage for most passengers. There are too many limitations and lower coverage than independent policies. Some of my clients have taken it, however, because of the cancel for any reason provisions which just weren't available in independent policies. Finally, that rider is now available through companies such as TravelGuard and CSA.

The Cruises Inc. TravelGuard policy now has an option to add cancel for any reason coverage. For a slight surcharge, it adds coverage which allows you to cancel up to 48 hours prior to departure for any reason, such as a work situation, pet emergency, or other non-covered event. The coverage will give you a 75% cash refund in this situation, while medical covered events would still be covered at 100%. It's a terrific option for those who have aging pets, uncertain work schedules or other life situations which don't fall into the traditional medical coverage.

There are also coverages available through TravelGuard and CSA which just cover cancellation for work situations. These are a lesser cost than the cancel for any reason provision, and for many cover the most likely scenario.

I am a licensed insurance agent and represent both TravelGuard and CSA. If you find that the general Cruises Inc. policy isn't the best fit for your situation, know that I can assist you with the purchase of any policy TravelGuard and CSA offers, as well as answer your questions on what policies might be best for your particular needs, including pre-existing conditions.

Insurance is confusing. I know. Fortunately there are new options out there which help make the decision easier to be covered for your specific coverage preferences and which address our changing lives. Talk with me about your insurance questions!